Irrigation apparatus and method for suction catheters

ABSTRACT

A cased suctioning catheter assembly with a protective flexible sheath around the catheter tube, has a thumb or finger operable pump located near the patient end of the catheter assembly. This pump receives irrigation fluid from a bag hanging on an IV stand and, when operated, pumps it into an irrigation lumen in the suction catheter on an as-needed basis during suctioning. Thereby one hand of the administrator can both stabilize the cross piece at the patient end of the suction catheter assembly and operate the irrigator, while the other hand controls vacuum flow as needed for the suctioning function.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates generally to suction catheters, and moreparticularly to a method and apparatus for keeping them clear so thateffective suctioning can be maintained.

2. Description of the Prior Art

In the use of endotracheal tubes, regardless of whether passed throughthe mouth or through a tracheotomy, there are times when lung secretionsare too thick and sticky to be easily extracted through a suctioncatheter. Dilution helps thin the secretions and irrigate the catheterlumen so good vacuum flow is maintained, thereby promoting removal oflung secretions which must be removed from the lung.

The current practice of irrigation uses syringes or compressable vialsas means of instilling the irrigation solution into the lung along theexterior of the catheter or through a lumen inside the wall of thecatheter in order to promote dilution. This practice requires more thantwo hands or the interruption of the suction flow in order to instillthe irrigating fluid into the system. A break in the suction flow maycause the secretion pool to be incompletely removed. Also, there is thepossibility that the volume of irrigation fluid from the single loadedsyringe or vial may not be adequate and will require a reload effort.

SUMMARY OF THE INVENTION

Described briefly, according to a typical embodiment of the presentinvention, a thumb or finger operable pump is located near the patientend of the suctioning catheter assembly. This pump receives theirrigation fluid from a comparatively large reservoir and can withdrawthe fluid from the reservoir and pump it into an irrigation supplychannel in the suction catheter on an as-needed basis during suctioning.Thus, the one hand of the administrator can both stabilize the junctionpiece at the patient end of the suction catheter and operate theirrigator while the other hand controls vacuum flow and catheterlocation as needed for the suctioning function.

BRIEF DESCRIPTION OF THE DRAWING

The single FIGURE of drawing is a schematic illustration of a casedsuction catheter situated for use through a tracheotomy and employingirrigation according to the method and apparatus of the presentinvention.

DESCRIPTION OF THE PREFERRED EMBODIMENT

For the purposes of promoting an understanding of the principles of theinvention, reference will now be made to the embodiment illustrated inthe drawings and specific language will be used to describe the same. Itwill nevertheless be understood that no limitation of the scope of theinvention is thereby intended, such alterations and furthermodifications in the illustrated device, and such further applicationsof the principles of the invention as illustrated therein beingcontemplated as would normally occur to one skilled in the art to whichthe invention relates.

Referring now to the drawing, a cased suction catheter assembly 11 ofthe general type shown in my U.S. Pat. No. 5,125,893, issued Jun. 30,1992, is provided with a four-way junction or cross piece 12 at thepatient end (where the tee piece 17, shown in FIG. 1 of that patent, waslocated in the patent) and to which is connected an endotracheal tube 13entering the trachea (not shown) through a tracheotomy 14 in the neck 16of the patient. The flexible sheath 17 is connected and sealed to asleeve 21 received on the end of the cross piece opposite theendotracheal tube. The distal end of the sheath is connected and sealedto the manifold 18.

A catheter tube 19 is fixed in the manifold 18 but slidably received inthe sleeve 21 which may have a valve in it (such as valve 23 shown inFIG. 1 in the above-mentioned patent). The catheter tube 19 has aninternal lumen 22 which is like and has the same purpose as the lumen 29in the catheter tube 20 of the aforementioned patent. The patient end ofthe catheter tube is open at 23 and the lumen 22 opens in the side ofthe catheter at the patient end at opening 24 from which irrigationfluid can be discharged into the lung around the catheter.

The lumen 22 communicates with the irrigation fluid supply tube 26connected to the manifold 18. A suction tube 28 is connected to themanifold 18 and through it to the catheter tube 19. However, thissuction line is independent of and isolated from the lumen 22 andassociated tube 26. A manually operable vacuum control valve 29 isassociated with the vacuum line 28 at the manifold. The valve isnormally closed but can be opened by the thumb 31 of the administrator.The line 28 is connected to a suction source 32.

An air/oxygen ventilating machine 33 is connected through hose 34 to thebottom stem 36 of the cross fitting 12. According to the illustratedembodiment of the present invention, a self-priming pump assembly 37 isconnected to the top stem 38 of the cross fitting. The intake port 39 ofthe pump is connected to a comparatively large reservoir such as an IVinfusion bag 41 which can be hung on arm 42A of an IV stand 42 by meansof the eyelet 41E at the top of the bag. The outlet line 43 of the bagis connected to the inlet port 39 of the pump assembly 37. The dischargeport 44 of the pump is connected through the tube 46 to a Y-connector 47which is, in turn, connected to the tube 26. A needle pierceable cap 48is provided at the upper end of the other branch of the Y-fitting 47 foraddition of material to the irrigation system from a syringe if, andwhen, desired. An overcap 49 on a flexible hinge 51 is provided on theupper end fitting of tube 26 to close that tube if the Y-connector 47 isremoved from it. Similarly, hinged overcap 50 is provided at the upperend of the tube 27.

Two one-way valves shown schematically at 45A and 45B are providedbetween the inlet and outlet ports 39 and 44 of the pump assembly 37.Thus, irrigating fluid can be drawn from line 43 through valve 45A intothe pump bellows, and squeezed out by pressure from the thumb of onehand of the administrator and through the one-way valve 45B into theline 46 and thereby through the tube 26 and lumen 22 and out through theopening 24 when in the patient's lung 52, as indicated by the dottedline in the drawing.

OPERATION

As one hand 53 stabilizes the cross fitting 12 and is in position foroperation of the pump with the thumb 54 when irrigation is needed, thecatheter tube 19 is pushed down into the lung by advancing the otherhand 56 forward in the direction of arrow 57. Suctioning can beincreased or decreased by decreasing or increasing the opening in vacuuminlet valve 29 by operating the thumb 31. Irrigation is applied asneeded by operating the pump 37 by pushing and releasing the upper endof the bellows with the thumb 54.

The pump, being securely attached to the patient end of the casedsuction catheter assembly at the cross piece 12, allows the hand thatstabilizes the cross piece to also activate the pump which refillsautomatically, thus permitting fluid irrigation as long as is needed.The other hand controls the vacuum flow as needed to complete thetreatment.

Although the above-described and illustrated pump system lines 46, 26communicate with an in-the-wall lumen 22 in the catheter, the pumpsystem and line 46 may be connected to line 27 for down-the-catheterlumen purge of the catheter 19 itself in those types of cased catheterswhich irrigate the interior of the catheter tube itself rather thanirrigating at the tip of the catheter. Alternatively or in addition, theirrigation line 46 can be at the patient connector for external wash ofthe catheter itself. An example would be connection to port 55 of thecatheter assembly shown in the U.S. Pat. No. 3,991,762 issued Nov. 16,1976 to Radford.

If there is any concern about possible confusion between IV lines andbottles with the irrigation system lines and bottles, the apparatus maybe sized and/or color coded, and the spike for entering the fluid bagwould not have a drip chamber. Similarly, the distal fitting that entersthe irrigation sites can be sized or keyed to prevent connection with anintravenous needle or IV lines.

The pump bellows illustrated, or cylinder if a piston pump is used, canbe filled from the bag many times by simply releasing thumb pressurefrom the valve button and without letting go of the catheter system atall. If a piston/cylinder pump is used, the piston pressure of the pumpcan be changed by the amount of thumb pressure on it. For differentsituations where nominal thumb pressure might be needed to produce moreor less pressure, the amount applied by a given amount of force on thethumb can be determined by selection of appropriate piston diameter.Since it is preferred that the pump be self-priming, the reservoir neednot be an elevated bag, but can simply be a bag or other containerresting on a surface in the patient area.

While the invention has been illustrated and described in detail in thedrawings and foregoing description, the same is to be considered asillustrative and not restrictive in character, it being understood thatonly the preferred embodiment has been shown and described and that allchanges and modifications that come within the spirit of the inventionare desired to be protected.

What is claimed is:
 1. Suction catheter apparatus comprising:an elongateflexible bag having two ends; a first connector fitting coupled to oneend of the bag; a second connector fitting coupled to the other end ofthe bag; an endotracheal tube coupled to the first connector fitting forintroduction to the trachea of a patient to be treated; a catheter tubeanchored to the second connector fitting and extending through the bagand the first connector fitting into the endotracheal tube; and a liquidmoving pump mounted to the first connector fitting for connection to asource of irrigation fluid, said pump having an operator member situatedadjacent the first connector fitting so as to be operable by a digit ofa hand holding the first connector fitting.
 2. The apparatus of claim 1and further comprising:a conduit from the pump to a point adjacent thecatheter tube to convey irrigation fluid from the pump to contact withthe catheter tube.
 3. The apparatus of claim 2 and wherein:the conduitis coupled to the second connector fitting.
 4. The apparatus of claim 3and further comprising:a lumen inside the catheter tube and extendingtherein from the second connector fitting to a point adjacent the end ofthe catheter in the endotracheal tube, the conduit being in fluidcommunication with the lumen to deliver irrigation fluid from the pumpto said point adjacent the end of the catheter.
 5. The apparatus ofclaim 1 and further comprising:an irrigating fluid reservoir holdingirrigating fluid and fluidly connected to the pump.
 6. The apparatus ofclaim 5 and wherein:the reservoir is an IV infusion bag.
 7. A method ofirrigating a suction catheter and comprising the steps of:holding apatient end fitting of a sheathed catheter tube apparatus in placeadjacent a trachea entrance, with one hand; holding a machine couplingend of the catheter tube apparatus with the other hand; and pumpingirrigation fluid to the catheter tube with a digit of the one handoperating the pump while holding the patient end fitting with the onehand.
 8. The method of claim 7 and further comprising the stepsof:supplying irrigating fluid to the pump from a fluid reservoir.
 9. Themethod of claim 7 and further comprising the steps of:applying suctionto the catheter while holding and pumping.
 10. The method of claim 9 andfurther comprising the steps of:controlling the amount of suctionapplied by operation of a valve at the machine coupling end of theapparatus with a digit of the other hand.